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Doody's Review ServiceReviewer: Lon Castle, MD (Baylor College of Medicine)
Description: Identification and management of fractures is an increasingly important aspect of primary care. With its extensive use of diagrams and x-rays to supplement the text, this book fulfills this need and will become an essential reference for any physician.
Purpose: Physicians need a quick guide for their busy offices that is less elaborate than the standard orthopedic text.
Audience: This book is intended for primary care physicians. Available orthopedic texts are more focused on operative techniques and complications than is needed for a primary care setting, making them cumbersome and ineffective. Its narrative text and layout, especially the description of the principles of fracture healing, also make it useful for residents and medical students. Although it additionally seeks to be a reference for nurse practitioners and physician assistants, certain concepts are not explained sufficiently to be useful for these allied health fields.
Features: This book does not attempt to present every type of orthopedic malady, but concentrates instead on the most common types of fractures and dislocations that occur in the spine and extremities. It is clearly written by individuals who are proficient in fracture management. In fact, the authors are well known nationally to most primary care physicians for their expertise in sports medicine. In order to share their insight, they have gone to great lengths to locate appropriate x-rays and design illustrations to demonstrate the various injuries. This underscores the concept that fracture evaluation is primarily a visual skill. In this instance, it is almost impossible to be overillustrated. The references are remarkably current. This acknowledges the recent philosophical changes in fracture management. Physicians, particularly those involved in sports medicine, have become much more aggressive in permitting athletes with fractures to return to play more quickly. Likewise, the management of stress fractures has changed. This book should mirror this by establishing a separate section for stress fractures. Also, there should be a section on casting, describing how to make the types of casts and splints described. The section on delayed complications should include arterial and neurologic problems as well as a cohesive discussion on compartment syndrome.
Assessment: This book is well-organized and easy to read. All fractures are discussed in a standard format that includes the anatomy, mechanism of injury, clinical signs and symptoms, radiographic findings, orthopedic concerns, and treatment. The tables used to outline treatment options are brilliant. The chapter on general principles of fracture care includes an excellent review of bone physiology for residents and medical students. This book generally succeeds in its desire to be a complete reference for fracture management. The illustrations, x-rays, and standard format to discuss fractures make it a perfect office reference. No other textbook on this subject is as concise or comprehensive. Medical bookstores will have a difficult time keeping this book on the shelves because every primary care physician will want a copy of it in the office.